Children with special health care needs (CSHCN) make up 15% of all children and account for the majority of pediatric health expenditures. Parents of CSHCN experience greater work disruptions than other parents, largely due to episodic exacerbations of their children's chronic illnesses. Thus, for parents of CSHCN, the availability and type of family leave may be critical. In July 2004, the California (CA) Paid Family Leave Insurance (PFLI) program took effect, providing 6 weeks of paid leave for most employees and making CA the first state to legislate paid family leave. This controversial program markedly expands the current federal family leave law, which guarantees only unpaid family leave. Because the employment and leave-taking needs and behaviors of parents of CSHCN are not well understood, the effects of new policies are difficult to predict. Before PFLI began, we completed a baseline phone survey of 570 parents of CSHCN in CA and 572 in Illinois (which does not have PFLI). Preliminary analyses suggest major conflicts between child illness and parent employment, as well as the importance of family leave. We seek funds to conduct follow-up surveys of baseline parents (for longitudinal analyses) and surveys of a new cohort of parents (for successive cohort analyses) about three years after the baseline survey. Our study, the first to assess PFLI's effects on employment, leave-taking, and child and parent health among families with CSHCN, will provide critical information for researchers, parents, policy-makers, employers, and clinicians. Our specific aims are to: (1) examine how PFLI, child illness, and other factors affect employment and leave-taking among parents of CSHCN;and (2) assess how use of PFLI and other family leave options affect parents'ability to care for children, children's quality of life, parents'mental health, and parents'employment.